Coronary Calcium Score

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Coronary Calcium Score (Heart Scan)

A CT scan for a Coronary Calcium Score is a convenient and noninvasive
way of evaluating an individual’s risk for a heart attack. This
scan shows the location and extent of calcified soft plaque in the walls
of coronary arteries. The Coronary Calcium Scoring scan takes 5-10 minutes
and is noninvasive so there is no pain and no injections. The results
of this scan help your physician detect coronary artery disease, which
is a leading cause of heart attacks in both men and women. St. Joseph
Medical Center uses a 128 and 64-sliceCT scanner for Coronary Calcium
Scoring. Our scanners are equipped with low-dose technology to limit radiation
exposure. This test is not covered by most health insurance or health
plans. The fee for the test is$40 dollars and can save your life. You may pay this fee by check, credit card or
cash at the time of service.

Why it's done

Coronary artery disease results in damage to the arteries primarily due
to plaque and inflammation. Plaque deposits in and on the walls of coronary
arteries can restrict the flow of oxygen-rich blood to the muscles of
the heart. Plaque also may burst, triggering a blood clot that can cause
a heart attack.

Plaque is composed of fats, cholesterol, calcium and other substances in
the blood. Plaque deposits develop gradually over time, long before there
are any signs or symptoms of disease. The imaging test provides an early
look at calcium levels. If there is calcium, then there is already some
stiffening and narrowing of the artery (atherosclerosis).

A heart scan uses a specialized X-ray technology called multidetector row
or multislice computerized tomography (CT), which creates multiple images
of the calcium deposits. The amount of detected calcium provides a measure
of how much plaque has accumulated, and the data from the scan are used
to calculate a score. When combined with other health information, your
doctor may use the test score to refine a treatment plan for reducing
your risk.

When is a heart scan used?

A heart scan is generally considered useful for people who have a known
moderate risk of heart disease or when the risk is uncertain. There are
different tools for an initial risk assessment, but all of them use factors,
such as your age, sex, blood pressure, cholesterol levels and tobacco
use. A moderate risk is generally defined as a 5 to 7.5 percent chance
of a heart attack in the next 10 years or when the risk is calculated
to be low, but there is a history of heart attacks at an early age in
the family.

The American College of Cardiology and the American Heart Association guidelines
published in 2013 on cardiovascular risk assessment suggested that it
would be reasonable to perform coronary calcium heart scans for people
with a calculated risk of 5 to 7.5 percent or when "a risk-based
treatment decision is uncertain."

Some studies have demonstrated that a heart scan may be a motivational
factor for people at moderate risk to make lifestyle changes and follow
treatment plans.

When is a heart scan not used?

A heart scan does result in radiation exposure. While this exposure is
generally considered safe, it is not recommended when there is no likely
benefit to getting the scan. In other words, when the scan is not likely
to provide any information that is useful in defining your risk or directing
a treatment plan, the risk of radiation exposure outweighs any potential benefit.

According to the American College of Cardiology and the American Heart
Association guidelines, a heart scan is generally not recommended for
the following people:

· Men under age 40 and women under age 50, because detectable calcium
at younger ages is not likely

· People who have a low risk, because detectable calcium is highly
unlikely, in the absence of family history of heart attacks at early age

· People who already have a known high risk, because the heart scan
will likely not provide any additional information to guide treatment decisions

· People who already have symptoms or a diagnosis of heart disease,
because the procedure would not help doctors better understand the disease
progression or risk

· People who already had an abnormal coronary calcium heart scan

Risks

Heart scans use a type of X-ray technology. Therefore, you are exposed
to radiation. The amount of exposure is generally considered safe —
about the same amount of radiation you're naturally exposed to in
a year. Your own history of exposure from other medical tests will help
your doctor and you discuss your relative risk.

How you prepare

When you schedule your appointment for a heart scan at a hospital or outpatient
medical center, ask what special instructions you should follow, how early
you should arrive, and what paperwork or identification you will need.

Food and medications

You may be asked to avoid caffeine and smoking for four hours before the test.

Clothing and personal items

When you arrive for the procedure, you will be asked to remove clothing
above the waist and to wear a medical gown. You will also need to remove
jewelry around your neck or near your chest. In order to make things easier
for yourself, you can consider leaving jewelry at home and wearing clothes
that are easy to change.

What you can expect

During the procedure

Before the actual scan begins, the technologist will attach sensors, called
electrodes, to your chest. These are attached to an electrocardiogram
(ECG or EKG), which will record your heart activity during the exam and
coordinate the timing of X-ray pictures between heartbeats, when the heart
muscles are relaxed.

During the heart scan, you will lie on your back on a movable table. The
table will slide you into the tubelike CT scanner. Your head will be outside
the scanner the whole time. The exam room will likely be cool.

During the procedure we
do not give any medication either by pill or injection that slows your heart
to ensure clear images. If you are nervous or anxious, you may be given
medication to help you remain calm.

The technologist will operate the scanner from a room next door. He or
she will be able to see you and communicate with you. The technologist
will ask you to lie still and hold your breath for a few seconds while
the X-ray pictures are taken. The machine will make clicking and whirring
sounds, and the entire procedure should take 10 to 15 minutes.

After the procedure

There usually aren't any special precautions you need to take after
having a heart scan. You should be able to drive yourself home and continue
your daily activities.

Results

The result of the test is usually given as a number called an Agatston
score. The score represents a combination of information that reflects
the total area of calcium deposits and the density of the calcium.

A score of zero means no calcium is present in the heart and suggests a
low likelihood to develop a heart attack in the future. When calcium is
present, the higher the score, the higher the risk of attacks in the long
term. A score of 100 to 300 — moderate plaque deposition —
is associated with a relatively high risk of heart attack or other heart
disease over the next three to five years. A score greater than 300 indicates
very high to severe disease and heart attack risk.

You also may receive a percentile score, which indicates your amount of
calcium relative to people of the same age and sex.

Discussing results with your doctor

Your doctor will discuss the results of the heart scan with you. Depending
on the outcome, he or she may recommend:

· Continuing the current course of treatment

· Changing medications

· Changing your diet and exercise routine

· Setting new weight-loss goals

· Ordering additional tests

· Planning for follow-up appointments to monitor your health and
adherence to a treatment plan